不同频率针刺疗法对脑卒中后肱二头肌痉挛的影响  

Clinical study of acupuncture therapy on spastic muscle in stroke patients

作　　者：林强[1] 陈安亮[1] 程凯[1] 周奕戈[1] 周俊[1] 高明霞[1] 袁冰[1] 李雪萍[1] 

机构地区：[1]南京医科大学附属南京医院康复医学科,江苏省210006

出　　处：《老年医学与保健》2016年第2期113-115,123,共4页Geriatrics & Health Care

基　　金：南京医科大学科技发展基金面上项目(2010NJMU056);南京市科技发展基金重点项目(201104017)

摘　　要：目的研究不同频率针刺痉挛肌附近穴位对脑卒中后肢体肌痉挛的影响,探索针刺肌痉挛的有效手法操作规律。方法脑卒中患者60例,随机分为高频捻转针刺组和低频捻转针刺组两组,每组30例。以痉挛肌肱二头肌附近的天泉穴为施术穴位,根据组别分别采用高频捻转针刺手法和低频捻转针刺手法,操作2分钟,留针20min后取针。采用表面肌电测定痉挛肌肱二头肌肌腹处的均方根值(RMS),所有患者均采用改良Ashworth量表、Barthel指数进行评定。结果针刺前两组患者的RMS值、改良Ashworth分级、Barthel指数评分比较无统计学差异(P>0.05);与针刺前比较,两组患者针刺后RMS值均降低,差异有统计学意义(P<0.05),Barthel指数评分均增加(P<0.05),而改良Ashworth分级无差异(P>0.05);与高频捻转针刺组比较,低频捻转针刺组治疗后RMS值降低(P<0.05),而改良Ashworth分级、Barthel指数评分无差异(P>0.05)。结论低频率捻转手法针刺痉挛肌附近穴位能更好的降低痉挛肌张力。Objective To investigate the effect of different frequency acupuncture on acupoints near spastic muscle after stroke, and explore effective manipulation regularity of acupuncture on spastic muscle. Methods Sixty stroke patients were randomly divided into high frequency torsional acupuncture group （HF group） and low frequency torsional acupuncture group （LF group）, with 30 cases in each group. Acupoints is Tianquan point near the spastic biceps. According to groups, patients were treated with high-frequency twisting acupuncture or low frequency twisting acupuncture. Each patient was acupuncture for 2 minutes, and retained needle for 20 minutes, then remove needle. Root mean square （RMS） of spasm biceps muscle was detected by surface myoelectricity （SEMG）. All patients were assessed by Modified Ashworth Scale （MAS） and Barthel index （BI）. Results Before acupuncture, there is no statistical difference in RMS, MAS and BI between two groups （P〉0.05）; for two group of patients, RMS values after acupuncture were significantly lower than those before acupuncture （P〈0.05）. The BI after acupuncture were significantly increased （P〈0.05）. The MAS after acupuncture was not significantly changed （P〉0.05）. Compared with HF group, RMS value after acupuncture in LF group was significantly decreased （P〈0.05）. There was no significant difference in MAS and BI after acupuncture between HF group and LF group （P 〉 0.05）. Conclusion Low frequency torsional acupuncture in acupoints near spastic muscle is a better choice for reducing spastic muscle tension.

关 键 词：针刺治疗 脑卒中 痉挛肌 表面肌电 

分 类 号：R246.6[医药卫生—针灸推拿学]